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Individual

MATIA GJELLSTAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
101 3RD AVE SW, MINOT, ND 58701-3880
(701) 857-5286
(701) 857-5694
Mailing address
PO BOX 5020, MINOT, ND 58702-5020
(701) 857-5000
(701) 857-5646

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1268
ND

Other

Enumeration date
12/05/2014
Last updated
12/05/2014
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